This study investigates the effectiveness of child and adolescent mental health services (MHS) in a naturalistic setting. The study involved 2230 (pre)adolescents from the TRacking Adolescents’ Individual Lives Survey (TRAILS) with a 76% response rate, an average age of 11.09 years at baseline, and approximately 50.8% female participants. Covering a six-year period across the first three assessment waves, the research used multiple linear regression analysis, propensity score matching, and data validation to examine the emotional and behavioural problem trajectories of adolescents who did and did not use MHS.
The findings suggest that adolescents who utilized MHS did not show significant improvement in their emotional and behavioural problem scores over time compared to those who did not use MHS. Specifically, while the problem scores of non-MHS users decreased over time, those of MHS users remained high. Limited MHS use was associated with a slight decrease in problem scores, though not as pronounced as for those without any MHS use, and continuous MHS use was linked to persistently high problem scores. Importantly, the study accounted for factors such as baseline severity, adolescent vulnerability or resilience, and stressful life events, and utilized multiple outcome measures and imputation methods to validate the results.
A key limitation of the study is the lack of detailed information on the duration and specific nature of the MHS treatments received by participants.
Despite this, the authors conclude that the benefits of MHS for adolescents in real-world settings are questionable and call for replication studies to determine whether these findings reflect a need for critical examination of everyday care or are due to artifact.